Passenger Locator Form

STATUS: NON-RED LIST

VACCINE STATUS: VERIFIED FULL/EXEMPT

The code contains personal

information. By sharing the code,
you will be sharing your passenger
locator form data.

Summary
Name ashira Darwish Ramadan
Passport number 33513832
Which company are you travelling with? EasyJet
What is the flight number, train number or ship EZY8818
name that you will arrive on?
Reference UKVI_5ZAA033448771
Status NON-RED LIST
Are you required to book a COVID-19 test Yes
package for when you arrive in the UK?
Your test package booking reference GTETY1588341
Arrival location London Gatwick Airport (LGW)
Date of arrival 10 February 2022 21:45 Greenwich Mean Time
(GMT)
Date of submission 10 February 2022 08:08 Greenwich Mean Time
(GMT)

ashira Darwish Ramadan Page 1 of 4

 UK Visas & Immigration

Personal information

Email address ashiraram@gmail.com

Travel information

Do you have an address for where you will stay Yes

during your first 10 days in the UK?

Who are you planning to stay with in the UK? Carmel Darwish

What address will you stay at for your first 10 days 10 Fencote
in the UK? Bracknell
RG12 0TD

When will you arrive there? 10 February 2022

When will you leave there? 20 February 2022

Where will you arrive in the UK? London Gatwick Airport (LGW)

What country or territory are you travelling from? Israel and/or Jerusalem (including East Jerusalem
(part of the Occupied Palestinian Territories))

Which company are you travelling with? EasyJet

What is the flight number, train number or ship EZY8818

name that you will arrive on?

Your cabin type or your coach number Aircraft - Economy

Which countries or territories have you been in, or Israel and/or Jerusalem (including East Jerusalem
will you be in, for the 10 days before coming to the (part of the Occupied Palestinian Territories))
UK?

Did you transit through this country or territory via No

plane or train without passing Border Control?

Have you visited, or will you visit, any islands in this No

country or territory during the 10 days before you
arrive in the UK?

Arrival date (optional) 10 February 2022

Departure date 10 February 2022

Are you required to book a COVID-19 test package Yes

for when you arrive in the UK?

ashira Darwish Ramadan Page 2 of 4

 UK Visas & Immigration

Your test package booking reference GTETY1588341

Your dates of travel

Which date do you plan to arrive in the UK? 10 February 2022 21:45 PM

When do you plan to leave the UK? (optional) 10 February 2022

Personal information

Given name(s) ashira

Family name / Surname Darwish Ramadan

What is your sex? Female

Is your home address in the UK? No

Home address 12 Jubran Khalil

Maalot Tarshiha
AA
Israel

How can we contact you when you are in the UK? I can be contacted by phone call and text message
(SMS)

Date of birth 30 June 1984

Your primary phone number +44 07809440448

Do you meet the COVID-19 vaccination eligibility Yes

criteria for reduced isolation and testing
requirements?

Do you have a QR code that you can use to verify Yes

your vaccination status?

How would you like to provide proof of your Attach a file or screenshot containing a QR code
vaccination status?

Have you provided proof of your vaccination Yes

status?

How do you meet the COVID-19 vaccination status I am fully vaccinated by a recognised programme
eligibility requirements?

Which country or territory did you receive your Israel

ashira Darwish Ramadan Page 3 of 4

 UK Visas & Immigration
COVID-19 vaccination(s) in?

Passport and travel document details

Passport number or travel document reference 33513832

number

Country or territory of issue Israel (ISR)

Expiry date 18 May 2024

People you are travelling with

Are you travelling to the UK with anyone under 18 Yes

years old that you are including on this form?

Given name(s) lyra

Family name / Surname dajani

Relationship to you child

Date of birth 10 November 2020

Is the person you are including 12 to 17 years old? No

Declaration
I declare that:

I understand I have to provide proof of my negative PCR or LFD coronavirus (COVID-19) test result, unless
I am exempt or meet vaccine eligibility criteria
I understand that I must bring proof of my COVID-19 vaccination status if I meet the eligibility criteria. My
proof of vaccination status (if declared) contains my full name, date of birth, vaccine brand and
manufacturer, the dates for all my vaccination doses and the country of vaccination and/or certificate
issuer
The information I have entered in this form is correct
I understand it could be a criminal offence to provide false details and I may be prosecuted

I confirm that I understand and agree with the above declarations.

ashira Darwish Ramadan Page 4 of 4